Making an insurance claim through your superannuation fund can be a complex and stressful process — particularly if it follows a death or serious illness. Here’s a clear overview of how super insurance claims work in Australia.
Step 1 — Contact Your Super Fund
The first step is to contact your super fund’s member services team and notify them of the claim. They will:
- Confirm the type of insurance you hold and your cover amount
- Send you (or your legal representative) a claims pack with the required forms
- Assign a claims case manager
Contact options:
- Phone: Member services number on your fund’s website or statement
- Online: Many funds have online claims portals (log in to your account)
- In writing: Formal written notification for TPD or death claims is often required
Step 2 — Gather Documentation
Different claim types require different documentation:
Death Claim
- Death certificate
- Grant of probate or letters of administration (for estate claims)
- Proof of identity for claimants
- Completed claims form signed by the legal personal representative or nominated beneficiaries
TPD Claim (Total and Permanent Disability)
- Detailed medical reports from treating doctors and specialists
- Evidence of inability to work — employment records, specialist assessments
- Completed TPD claims form
Income Protection Claim
- Medical certificate confirming the illness or injury
- Proof of pre-disability income (payslips, tax returns)
- Completed IP claims form
- Ongoing medical updates during the benefit payment period
Step 3 — The Assessment Process
Once the fund receives your completed claim:
- The trustee (through the insurer) assesses the claim against the policy terms
- They may request additional medical evidence or an independent medical examination (IME)
- For TPD claims, functional capacity assessments may be arranged
- The insurer provides a decision to the trustee, who makes the final claim determination
Timeframes: Income protection claims may be resolved in 4–8 weeks. Death and TPD claims are typically more complex and can take 3–12 months, sometimes longer for disputed claims.
Step 4 — Receiving the Benefit
Death benefits: The trustee must determine who the benefit is paid to — based on your binding nomination (if valid) or the trustee’s discretion. If there is a binding nomination, payment is typically faster.
TPD and IP benefits: Paid directly to the member. TPD lump sums from super are taxed depending on age and the fund’s tax components. IP benefits are taxable income.
If Your Claim Is Disputed or Denied
If your claim is denied or you disagree with the decision:
- Internal dispute resolution (IDR): First step — formally ask the fund to review the decision
- Australian Financial Complaints Authority (AFCA): If IDR is unsatisfactory, lodge a complaint with AFCA (free service, binding determinations)
- Legal action: If AFCA is not appropriate (very large claims), specialist insurance/super lawyers can assist
AFCA handles the majority of super insurance disputes and has awarded significant amounts to members whose claims were wrongly denied.
Getting Help With a Claim
Super insurance claims — particularly TPD claims — can be complex, and insurers may dispute claims. Consider:
- Financial rights legal centre: Free legal advice for insurance disputes
- Insurance claims lawyers: Specialists in super TPD and death claims (often no-win no-fee)
- Super Consumers Australia: Advocacy and information resource
For more: Death Cover in Super, TPD in Super, Income Protection in Super, Pre-Existing Conditions in Super Insurance. For advice on your situation, speak with a licensed financial adviser via MoneySmart.